In a cross-sectional study of 2,090 patients aged 18–40 with confirmed hypertension who were referred to a French hospital (with difficult-to-control BP or concern of secondary causes) and underwent full screening, 29.6% were found to have a secondary cause1.
Primary aldosteronism was the most frequent diagnosis (54.8%), followed by renovascular hypertension (18.4%), kidney disease (12.9%), pheochromocytoma or paraganglioma (5.9%), drug-related hypertension (6.0%), and other rare causes.
Notably, having blood pressure below 160/100 mm Hg did not reduce the likelihood of secondary hypertension. Prevalence was higher in those aged 30-40 than in those aged 18-30.
Factors associated with increased risk included female sex, hypokalemia, treatment with two or more medications, absence of family history, BMI under 25, and diabetes.
The authors conclude that all hypertensive patients under 40 should be screened for secondary causes.
As published in NZ Doctor and Research Review
